Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 21 - MENTAL HYGIENE REGULATIONS
Chapter 10.21.12 - Use of Quiet Room and Use of Restraint
Section 10.21.12.08 - Clinical Interventions During Restraint

Universal Citation: MD Code Reg 10.21.12.08

Current through Register Vol. 51, No. 19, September 20, 2024

A. Regardless of the physical setting in which the patient is placed, at a minimum, one staff member shall be assigned continuously while the patient is in a category I restraint.

B. While the patient is restrained, in order to provide appropriate clinical care, at a minimum, staff clinically trained to do so shall:

(1) Keep the patient in full view at all times;

(2) Protect the patient from harm by others;

(3) Closely observe the patient at least every 15 minutes, and document each observation by the observer;

(4) Unless contraindicated by circumstances as assessed and documented by a physician or registered nurse, at least hourly, make and document personal contact with the patient for the purpose of:
(a) Determining if the patient has any special needs which need attention;

(b) Checking circulation of the extremities restrained;

(c) Adjusting the restraint; and

(d) Realigning the body or massaging the extremities restrained, or both;

(5) Unless contraindicated by circumstances as assessed and documented by a physician or registered nurse, offer or provide the following:
(a) Full range of motion, every 2 hours;

(b) Toilet facilities, at least every 2 hours;

(c) Bathing and oral hygiene, at least once during a 24-hour period;

(d) Meals, at the regularly scheduled hours and under the supervision of nursing personnel; and

(e) Fluids, at least every 2 hours; and

(6) As clinically indicated, record temperature, pulse, blood pressure, and respirations.

C. At least once every 2 hours, a physician or registered nurse shall assess the appropriateness of continuing the restraint and document the factors supporting the assessment in the patient's medical record.

D. Unless circumstances suggest a medical problem may exist, staff may not disrupt a patient's sleep during the night to implement the clinical procedures described in §§B and C of this regulation.

Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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